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Deng Y, Zhang Z, Gui Y, Li W, Rong T, Jiang Y, Zhu Q, Zhao J, Zhang Y, Wang G, Jiang F. Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children. JAMA Netw Open 2023; 6:e2347623. [PMID: 38095895 PMCID: PMC10722331 DOI: 10.1001/jamanetworkopen.2023.47623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/31/2023] [Indexed: 12/17/2023] Open
Abstract
Importance Sleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified. Objective To examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs). Design, Setting, and Participants This cohort study used data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023. Exposures Sleep disturbances were assessed using the Children's Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire. Main Outcomes and Measures Occurrence of incident and resolved EBDs at the 2-year follow-up. Results The cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P < .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P < .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P < .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P < .001) were higher than among the group with no sleep disturbances. Conclusions and Relevance In this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.
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Affiliation(s)
- Yujiao Deng
- Department of Neurology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zichen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education–Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiding Gui
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education–Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wen Li
- Department of Pediatrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tingyu Rong
- Department of Child and Adolescent Healthcare, Children’s Hospital of Soochow University, Suzhou, China
| | - Yanrui Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education–Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Zhu
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education–Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jin Zhao
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Child Health Advocacy Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunting Zhang
- Child Health Advocacy Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guanghai Wang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education–Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
| | - Fan Jiang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Ministry of Education–Shanghai Key Laboratory of Children’s Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China
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2
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Klein Schaarsberg RE, Ribberink AZ, Osinga B, van Dam L, Lindauer RJL, Popma A. Treatment Responsivity in Adolescents With Disruptive Behavior Problems: Co-Creation of a Virtual Reality-Based Add-On Intervention. JMIR Form Res 2023; 7:e46592. [PMID: 38015607 DOI: 10.2196/46592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/07/2023] [Accepted: 07/27/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND We developed Street Temptations (ST) as an add-on intervention to increase the treatment responsivity of adolescents with disruptive behavior problems. ST's primary aim is to improve adolescents' mentalizing abilities in order to help them engage in and benefit from psychotherapy. Additionally, virtual reality (VR) is used to work in a more visual, less verbal, fashion. OBJECTIVE By recapping the lessons learned while developing ST so far, we aim to design the following study on ST. Furthermore, we aim to enhance the development and study of new health care interventions in clinical practice, together with adolescents as their end users. METHODS We followed an iterative co-creation process to develop a prototype of ST, in collaboration with adolescents and professionals from a secured residential facility in Amsterdam, the Netherlands. The prototype was tested during a pilot phase, involving 2 test runs, in which 4 adolescents and 4 professionals participated. Qualitative data were collected through interviews with the adolescents and by conducting a group interview with the professionals, in order to gain first insights into ST's usability, feasibility, and its added value to clinical practice. In between the first and second test runs, the prototype was enhanced. On the basis of the complete pilot phase, we reflected on the future development and implementation of ST to design a subsequent study. RESULTS Over the course of 6 months, ST's first prototype was developed during multiple creative sessions. Included was the development of a short 360° VR video, to serve as a base for the mentalization exercises. The final version of ST consisted of 7 individual therapy sessions, incorporating both the VR video and a VR StreetView app. On the basis of the qualitative data collected during the pilot phase, we found preliminary signs of ST's potential to support adolescents' perspective-taking abilities specifically. Additionally, using VR to focus on real-life situations that adolescents encounter in their daily lives possibly helps to facilitate communication. However, several challenges and requests concerning the VR hardware and software and the implementation of ST emerged, pointing toward further development of ST as an add-on intervention. These challenges currently limit large-scale implementation, resulting in specific requirements regarding a subsequent study. CONCLUSIONS In order to gather more extensive information to shape further development and study treatment effects, a small-scale and individually oriented research design seems currently more suitable than a more standard between-subjects design. Using the reflection on the lessons learned described in this report, a research protocol for a forthcoming study on ST has been developed. By presenting our co-creation journey thus far, we hope to be of inspiration for a more co-creative mindset and in that way contribute to the mutual reinforcement of science and clinical practice.
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Affiliation(s)
- Renée E Klein Schaarsberg
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Garage2020, Dutch innovation network for societal youth challenges, Amsterdam, Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, Netherlands
| | - Amber Z Ribberink
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Babette Osinga
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Levi van Dam
- Garage2020, Dutch innovation network for societal youth challenges, Amsterdam, Netherlands
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Ramón J L Lindauer
- Mental Health, Amsterdam Public Health, Amsterdam, Netherlands
- Child and Adolescent Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
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3
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Brady RG, Donohue MR, Waller R, Tillman R, Gilbert KE, Whalen DJ, Rogers CE, Barch DM, Luby JL. Maternal emotional intelligence and negative parenting affect are independently associated with callous-unemotional traits in preschoolers. Eur Child Adolesc Psychiatry 2023; 32:2303-2311. [PMID: 36063216 PMCID: PMC10163950 DOI: 10.1007/s00787-022-02074-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/19/2022] [Indexed: 12/15/2022]
Abstract
Deficits in emotion intelligence (EI) are a key component of early-childhood callous-unemotional (CU) traits. Children's EI may be influenced by their mother's EI through both familial genetic and environmental mechanisms; however, no study has directly tested the role of maternal EI in the development of CU traits. This study investigated whether maternal EI had a direct relationship with children's CU traits when controlling for the potential influence of parenting affect and other psychiatric diagnoses. Mothers and their 3- to 5-year-old preschoolers (N = 200) were recruited as part of a parent-child interaction-emotion development therapy treatment trial for preschool clinical depression and comorbid psychopathology. Using data collected prior to treatment, regression models tested whether maternal EI was related to children's CU traits, which specific aspects of maternal EI were most strongly associated with CU traits, and whether associations held after accounting for observed parenting affect. Maternal EI (p < 0.005), specifically the ability to understand others' emotions (p < 0.01), was significantly associated with children's CU traits. This relationship was specific, as maternal EI did not predict depression or oppositional defiant disorder. Both maternal EI and observed negative parenting affect were independently and significantly related to CU traits (p < 0.05) in a combined model. Given that maternal EI and observed negative parenting affect were independent predictors of CU traits in preschoolers with comorbid depression, findings suggest that current treatments for CU traits that focus solely on improving parenting could be made more effective by targeting maternal EI and helping mothers better model emotional competence.
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Affiliation(s)
- Rebecca G Brady
- Division of Biology and Biomedical Sciences, Washington University School of Medicine, 660 South Euclid Ave, Box 8514, St. Louis, MO, 63110, USA.
- Department of Neurology, Washington University School of Medicine, St. Louis, USA.
| | - Meghan Rose Donohue
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Philadelphia, USA
| | - Rebecca Tillman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
- Mallinckrot Institute of Radiology, Washington University School of Medicine, St. Louis, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
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4
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Seely HD, Gaskins J, Pössel P, Hautzinger M. Comprehensive Prevention: An Evaluation of Peripheral Outcomes of a School-based Prevention Program. Res Child Adolesc Psychopathol 2023; 51:921-936. [PMID: 36870013 DOI: 10.1007/s10802-023-01043-2] [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] [Accepted: 02/14/2023] [Indexed: 03/05/2023]
Abstract
By age 18, 22-27% of adolescents have experienced depressive symptoms increasing their risk of peripheral mental health and social issues. Despite the development of effective depression prevention programs, issues related to dissemination persist. This study aims to identify ways of increasing the likelihood of dissemination by a) investigating how prevention effects differ based on the professional background of the prevention program group leader and b) evaluating adolescent depression prevention in terms of comprehensive prevention - prevention with the breadth to reduce peripheral mental health and social issues. This cluster-randomized trial included 646 eighth-grade students recruited from German secondary schools. Adolescents were randomized into three conditions: teacher-led prevention, psychologist-led prevention, or school-as-usual. Results from hierarchical linear models reveal differences in effects based on implementation type and adolescent gender and provide preliminary evidence for a wider reach of depression prevention such that, regardless of implementation type or gender, the tested program was effective in reducing hyperactivity over time. Taken together, our findings warrant further research and suggest that depression prevention programs may have an effect on some peripheral outcomes, but not others, and that these effects may differ based on the profession of the group leader and adolescent gender. With continued empirical research investigating the efficaciousness of comprehensive prevention, this type of prevention has the potential to impact a larger proportion of the population and improve the cost-benefit ratio of prevention, thus increasing the likelihood of dissemination.
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5
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Tillem S, Dotterer HL, Goetschius LG, Lopez-Duran N, Mitchell C, Monk CS, Hyde LW. Antisocial behavior is associated with reduced frontoparietal network efficiency in youth. Soc Cogn Affect Neurosci 2023; 18:nsad026. [PMID: 37148314 PMCID: PMC10275549 DOI: 10.1093/scan/nsad026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 05/08/2023] Open
Abstract
Youth antisocial behavior (AB) is associated with deficits in socioemotional processing, reward and threat processing and executive functioning. These deficits are thought to emerge from differences in neural structure, functioning and connectivity, particularly within the default, salience and frontoparietal networks. However, the relationship between AB and the organization of these networks remains unclear. To address this gap, the current study applied unweighted, undirected graph analyses to resting-state functional magnetic resonance imaging data in a cohort of 161 adolescents (95 female) enriched for exposure to poverty, a risk factor for AB. As prior work indicates that callous-unemotional (CU) traits may moderate the neurocognitive profile of youth AB, we examined CU traits as a moderator. Using multi-informant latent factors, AB was found to be associated with less efficient frontoparietal network topology, a network associated with executive functioning. However, this effect was limited to youth at low or mean levels of CU traits, indicating that these neural differences were specific to those high on AB but not CU traits. Neither AB, CU traits nor their interaction was significantly related to default or salience network topologies. Results suggest that AB, specifically, may be linked with shifts in the architecture of the frontoparietal network.
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Affiliation(s)
- Scott Tillem
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Hailey L Dotterer
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Leigh G Goetschius
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Nestor Lopez-Duran
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Colter Mitchell
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Christopher S Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Luke W Hyde
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
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6
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Smajdor A. Reification and assent in research involving those who lack capacity. JOURNAL OF MEDICAL ETHICS 2023:jme-2022-108710. [PMID: 36690468 DOI: 10.1136/jme-2022-108710] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
In applied ethics, and in medical treatment and research, the question of how we should treat others is a central problem. In this paper, I address the ethical role of assent in research involving human beings who lack capacity. I start by thinking about why consent is ethically important, and consider what happens when consent is not possible. Drawing on the work of the German philosopher Honneth, I discuss the concept of reification-a phenomenon that manifests itself when we fail to observe or respond to our fellow humans' need for recognition. I suggest that assent is a way of responding to this moral need for recognition, which exists independently of cognitive capacity. I will look at the circumstances in which consent cannot be obtained from human beings, and ask whether some of the same ethically important considerations that underpin the need for consent might be achieved through seeking assent. I discuss the ways in which this might be beneficial for researchers, for prospective research participants and for society at large.
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7
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Khalaf HKS, Martin AF, De Brito SA, Barker ED. The Underlying Mechanisms in the Association Between Traumatic Brain Injury in Childhood and Conduct Disorder Symptoms in Late Adolescence. Res Child Adolesc Psychopathol 2023; 51:709-725. [PMID: 36637701 PMCID: PMC10119055 DOI: 10.1007/s10802-022-01015-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/14/2023]
Abstract
The present study examined i) the direct association between traumatic brain injury (TBI) in childhood and conduct disorder symptoms in adolescence, ii) whether this effect is mediated by impulsivity and/or callous unemotional traits (CU traits), and iii) whether these indirect effects are moderated by childhood family adversity and adolescent substance use. Utilising data from the Avon Longitudinal Study of Parents and Children (ALSPAC), participants with head injury information up to 12 years (4.5 years, 5.4 years, 6.5 years, 8.6 years, 11.7 years) were identified and categorised into a TBI (n = 409), orthopaedic injury (n = 1469) or non-injury group (n = 5685). Psychosocial factors such as impulsivity at 13 years, CU traits at 13 years, childhood family adversity (between birth to 4 years) and substance use at 14 years were collated for moderated mediation analyses. Conduct disorder symptoms were assessed at 16 years of age. TBI and conduct disorder symptoms were positively associated, and this association was mediated by impulsivity but not CU traits. The indirect effects were higher in magnitude for individuals with higher levels of childhood family adversity. Adolescent substance use was not found to moderate the indirect effects between TBI and conduct disorder symptoms. These results were specific to TBI individuals, and not in participants with orthopaedic injury and no reported injuries. Targeting impulsivity and early family adversity may alleviate the risk of conduct disorder symptoms following TBI in childhood. These findings have important implications for informing neuro-rehabilitative and preventative measures in clinical and community settings.
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Affiliation(s)
- Hanan K S Khalaf
- Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Alex F Martin
- Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Edward D Barker
- Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
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Kou H, Luo W, Li X, Yang Y, Xiong M, Shao B, Xie Q, Bi T. Cognitive deficits for facial emotions among male adolescent delinquents with conduct disorder. Front Psychiatry 2022; 13:937754. [PMID: 36081455 PMCID: PMC9445197 DOI: 10.3389/fpsyt.2022.937754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/01/2022] [Indexed: 11/25/2022] Open
Abstract
According to the social-cognitive theory and the social-information-processing theory, individuals with conduct disorder, a persistent and repetitive pattern of problematic behavior, might have cognitive biases toward hostile facial expressions. However, according to the optimal stimulation/arousal theory, the stimulation-seeking theory and the fearlessness theory, individuals with conduct disorder might have less fear and show less response to hostile or threatening facial expressions. To reconcile the discrepancy, we examined the cognitive biases including attentional processing and working memory processing to emotional faces among adolescents with conduct disorder. 35 male adolescent delinquents with conduct disorder and 35 age-matched delinquents without conduct disorder completed a visual search task and a delayed-match-to-sample task to examine their attentional processing and working memory processing for sad, angry, happy, and fearful faces, respectively. It was found that conduct disordered individuals searched angry and fearful faces, rather than sad and happy faces, more slowly than individuals without conduct disorder. However, no difference in mnemonic processing for facial emotions was found between groups. The results indicated that male adolescent delinquents with conduct disorder showed deficits in attentional orientation to hostile and threatening faces, supporting the optimal stimulation/arousal theory, the stimulation-seeking theory and the fearlessness theory, but not the social-cognitive theory.
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Affiliation(s)
- Hui Kou
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Wei Luo
- The Institute of Ethnology and Anthropology, Chinese Academy of Social Sciences, Beijing, China
| | - Xue Li
- School of Criminal Justice, China University of Political Science and Law, Beijing, China
- Psychological Guidance Center, Zunyi Medical University, Zunyi, China
| | - Ye Yang
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Min Xiong
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Boyao Shao
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Qinhong Xie
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
| | - Taiyong Bi
- Center for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, China
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9
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Valdebenito S, Speyer L, Murray AL, Ribeaud D, Eisner M. Associations between Student-Teacher Bonds and Oppositional Behavior Against Teachers in Adolescence: A Longitudinal Analysis from Ages 11 to 15. J Youth Adolesc 2022; 51:1997-2007. [PMID: 35764714 PMCID: PMC9363334 DOI: 10.1007/s10964-022-01645-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/14/2022] [Indexed: 11/25/2022]
Abstract
Prior research has found evidence for a positive effect of student-teacher bonds on children's behavior. However, little research has investigated these relations following a transactional model of child development. This study investigated the bidirectional associations between student-teacher relationships and oppositional behaviors towards teachers using the 'Zurich Project on the Social Development from Childhood to Adulthood' (n = 1527; median ages 11, 13 and 15; 49% female). Results of a random-intercept cross-lagged panel model suggested that, among boys, positive student-teacher bonds at age 13 were associated with fewer teacher-reported oppositional behaviors two years later. The results indicated that negative interactions with teachers may be part of vicious cycles of poor relationships and increased levels of oppositional behavior, particularly for boys in late adolescence.
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Affiliation(s)
- Sara Valdebenito
- Institute of Criminology, University of Cambridge, Cambridge, UK.
| | - Lydia Speyer
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | - Manuel Eisner
- Institute of Criminology, University of Cambridge, Cambridge, UK
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
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10
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Picoito J, Santos C, Nunes C. Emotional and behavioural pathways to adolescent substance use and antisocial behaviour: results from the UK Millennium Cohort Study. Eur Child Adolesc Psychiatry 2021; 30:1813-1823. [PMID: 33140219 DOI: 10.1007/s00787-020-01661-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/09/2020] [Indexed: 11/27/2022]
Abstract
This study examines the emotional and behavioural pathways to adolescent substance use and antisocial behaviour. Using a sample of 17,223 participants from the UK Millennium Cohort Study, we applied parallel-process growth mixture modelling on emotional and behavioural symptoms in those aged 3-14 and employed latent class analysis to identify patterns of substance use and antisocial behaviours at age 14. We then performed a multinomial regression analysis to explore the association between emotional and behavioural trajectories and patterns of adolescent substance use and antisocial behaviours, including sociodemographic, family, and maternal factors. We found five trajectories of emotional and behavioural symptoms and four classes of adolescence substance use and antisocial behaviour. Children and adolescents in the 'high externalising and internalising' and 'moderate externalising' trajectories were more likely to belong to any problematic behaviour class, especially the 'poly-substance use and antisocial behaviours' class. Inclusion in the 'moderate externalising and internalising (childhood limited)' class was associated with higher odds of belonging to the 'alcohol and tobacco' class. These associations remained significant after adjusting for important sociodemographic and contextual factors, such as maternal substance use, poverty, and parental status. Interventions on adolescent health promotion and risk behaviour prevention need to address the clustering of substance use and antisocial behaviour as well as the significant influence of early and chronic internalising and externalising symptoms on the aetiology of these behaviours.
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Affiliation(s)
- João Picoito
- Department of Child and Adolescent Psychiatry, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, 3000-602, Coimbra, Portugal.
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
- Public Health Research Centre, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
| | - Constança Santos
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Department of Paediatrics, Centro Hospitalar Universitário Cova da Beira, Covilhã, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal
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Scherpbier ICA, Abrahamse ME, Belleman RG, Popma A, Lindauer RJL. Implementation of Virtual Reality to Parent-Child Interaction Therapy for Enhancement of Positive Parenting Skills: Study Protocol for Single-Case Experimental Design with Multiple Baselines (Preprint). JMIR Res Protoc 2021; 11:e34120. [PMID: 35594138 PMCID: PMC9166663 DOI: 10.2196/34120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/26/2022] [Accepted: 03/09/2022] [Indexed: 01/20/2023] Open
Abstract
Background Disruptive behavior is a common reason for young children to be referred to mental health care services worldwide. Research indicates that treatments for child disruptive behavior where parents are the primary agents of change are most impactful. Parent-Child Interaction Therapy (PCIT) is an effective parent management training program currently implemented in therapeutic settings within the Netherlands. Ongoing research into improving the effectiveness of PCIT is being done within these settings. To further promote the key elements of PCIT, this study focuses on creating the opportunity for parents to practice positive parenting skills more outside of the clinical setting by adding virtual reality (VR) as an additional homework element. PCIT has shown to make impactful long-term improvements in parental warmth, responsiveness, and the parent-child relationship. Through VR, parents practice the taught parenting skills out loud in the comfort of their own homes in VR scenarios. We expect that VR addition will innovatively increase the effectiveness of PCIT. Objective This study aimed to evaluate the added value of VR to PCIT by using a multiple baseline single-case experimental design (SCED). We expect to find that PCIT-VR will ameliorate positive parenting skills. By implementing the VR element, we secondarily expected that meeting the skill criteria will be achieved sooner, treatment completion rates will increase, and the parent-child relationship will be better, whereas parental stress and child disruptive behavior will decrease. Methods A total of 15 children (aged 2-7 years) with disruptive behavior and their parents will be followed throughout the PCIT-VR treatment. Using a multiple baseline SCED with 3 phases, 15 families will fill out questionnaires weekly, in addition to having pre- and posttreatment and follow-up measurements to monitor their positive parenting skills, child disruptive behavior, parenting stress, and VR progress. Moreover, quantitative information and qualitative interviews will be analyzed visually and statistically and summarized to provide a complete picture of experiences. Results As of February 2021, 6 families have been enrolled in the study at the moment of submission. Data collection is projected to be completed in 2023. Quantitative and qualitative results are planned to be published in peer-reviewed journals, as well as being presented at national and international conferences. Conclusions The SCED—with its phased design, randomization, and the opportunity to replicate and assess both individual and group treatment effects—and adaptability of the VR technology are the strengths of the study. The risks of increased type I errors, maturation effects, or technological failure will be mitigated with the right statistical support. This study aims to magnify the scope of the treatment through additional skill training, ultimately in support of routinely implementing VR within PCIT. International Registered Report Identifier (IRRID) DERR1-10.2196/34120
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Affiliation(s)
- Iza C A Scherpbier
- Amsterdam UMC Location University of Amsterdam, Child and Adolescent Psychiatry, Amsterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Pyschiatry, Amsterdam, Netherlands
- Faculty of Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Mariëlle E Abrahamse
- Amsterdam UMC Location University of Amsterdam, Child and Adolescent Psychiatry, Amsterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Pyschiatry, Amsterdam, Netherlands
- Faculty of Medicine, University of Amsterdam, Amsterdam, Netherlands
| | - Robert G Belleman
- Computational Science Lab, University of Amsterdam, Amsterdam, Netherlands
| | - Arne Popma
- Levvel, Academic Center for Child and Adolescent Pyschiatry, Amsterdam, Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, Netherlands
| | - Ramón J L Lindauer
- Amsterdam UMC Location University of Amsterdam, Child and Adolescent Psychiatry, Amsterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Pyschiatry, Amsterdam, Netherlands
- Faculty of Medicine, University of Amsterdam, Amsterdam, Netherlands
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12
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Structural Equation Modeling (SEM): Childhood Aggression and Irritable ADHD Associated with Parental Psychiatric Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910068. [PMID: 34639370 PMCID: PMC8507797 DOI: 10.3390/ijerph181910068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022]
Abstract
Background: Children with attention deficit hyperactivity disorder (ADHD) co-occurring with Oppositional Defiant Disorder (ODD) further present aggressive behavior and may have a depressive parent. A child with co-occurring ADHD and ODD has differentially higher levels of behavioral and emotional difficulties. Little is known about how the irritable subtype of ADHD in children mediates the development of parental symptomatology. This study aims to elucidate the direct or indirect influence of childhood disruptive ADHD with aggressive behavior on their parental symptom using Structural Equation Modeling (SEM). Methods: A total of 231 ADHD children and their parents completed the Swanson, Nolan, and Pelham Version IV questionnaire for symptoms of ADHD, Oppositional Defiant Disorder (ODD) scale for irritable symptoms, Child Behavior Check List (CBCL) for aggression, and Symptom Checklist (SCL) for parental symptom. Results: The three-factor confirmatory factor analysis (CFA) model found symptoms of inattention, hyperactivity/impulsivity, irritable ODD, and aggression were inter-related. Mediational analyses demonstrated ODD mediates symptoms directly predicting the risk of increasing ADHD severity. Disruptive child symptoms (ADHD + ODD + aggression) may increase the risk of depression-related symptoms in the parent. When the child’s aggression increases by one standard deviation (SD), parental psychiatric symptoms increase by 0.235 SD (p < 0.001). Conclusions: By this SEM pathway analysis, there is the correlation between the disruptive, more aggressive subtype of ADHD in children/adolescents and the existence of psychopathological symptomatology of their parents. ADHD + ODD + aggression in children should be classified as an irritable subtype of ADHD, warranting early diagnosis and intensive treatment.
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13
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Klein Schaarsberg RE, Popma A, Lindauer RJL, van Dam L. Effects of a virtual reality-based training program for adolescents with disruptive behaviour problems on cognitive distortions and treatment motivation: Protocol for a multiple baseline Single-Case Experimental Design (Preprint). JMIR Res Protoc 2021; 11:e33555. [PMID: 35594071 PMCID: PMC9140739 DOI: 10.2196/33555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 01/10/2023] Open
Abstract
Background Serious disruptive behavior among adolescents is a prevalent and often persistent problem. This highlights the importance of adequate and effective treatment to help adolescents with disruptive behavior problems react less hostile and aggressive. In order to create a treatment environment in which behavioral change can be enhanced, treatment motivation plays an essential role. Regarding treatment itself, a focus on challenging self-serving cognitive distortions in order to achieve behavioral change is important. Street Temptations (ST) is a new training program that was developed to address both treatment motivation and cognitive distortions in adolescents with disruptive behavior problems. One of the innovative aspects of ST is the use of virtual reality (VR) techniques to provide adolescents during treatment with visually presented daily social scenarios to activate emotional engagement and dysfunctional cognitions. By using the VR scenarios as an integral starting point of ST’s sessions and transferring the power of the VR experience into playful and dynamic exercises to practice social perspective–taking, adolescents are encouraged to reflect on both their own behavior and that of others. This focus on reflection is grounded in ST’s main treatment mechanism to influence treatment motivation and cognitive distortions, namely, mentalizing (ie, reflective functioning). Objective The aim of this study is to describe the research protocol to evaluate the effects of ST on treatment motivation and cognitive distortions. We take a closer look at the use of ST and the methodology used, namely, the repeated single-case experimental design (SCED). Methods The effects of ST are studied through a multiple baseline SCED, using both quantitative and qualitative data. In total, 18 adolescents from secure residential youth care facilities and secondary special education schools are randomly assigned to 1 of the 3 different baseline conditions. Throughout the baseline phase (1, 2, or 3 weeks), intervention phase (4 weeks), and follow-up phase (1, 2, or 3 weeks), daily measurements on treatment motivation and cognitive distortions are conducted. Secondary study parameters are assessed before baseline, after intervention, and after follow-up. Qualitative data are collected after intervention, as well as at 3 months and 6 months after the intervention. Results Data collection for this study started in November 2021 and is planned to be completed by August 2023. The results will be published in peer-reviewed journals and presented at national and international conferences. Conclusions ST aims to improve the disruptive behavior problems of adolescents. This study will be the first to gain insights into the effectiveness of ST. The strengths of this study include its thorough and individually focused design (SCED), the focus on a residential as well as a secondary special education setting, and the ecological validity. The implications for practice are discussed. Trial Registration Central Committee on Research Involving Human Subjects NL75545.029.20. Netherlands Trial Register NL9639; https://www.trialregister.nl/trial/9639 International Registered Report Identifier (IRRID) PRR1-10.2196/33555
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Affiliation(s)
- Renée E Klein Schaarsberg
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Dutch Innovation Network for Societal Youth Challenges, Garage2020, Amsterdam, Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Mental Health, Amsterdam Public Health, Amsterdam, Netherlands
- Academic Center for Child and Adolescent Psychiatry, Levvel, Amsterdam, Netherlands
| | - Ramón J L Lindauer
- Mental Health, Amsterdam Public Health, Amsterdam, Netherlands
- Academic Center for Child and Adolescent Psychiatry, Levvel, Amsterdam, Netherlands
- Child and Adolescent Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Levi van Dam
- Dutch Innovation Network for Societal Youth Challenges, Garage2020, Amsterdam, Netherlands
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
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14
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Hand ED, Lonigan CJ. Examining the Relations between Preschooler's Externalizing Behaviors and Academic Performance Using an S-1 Bifactor Model. Res Child Adolesc Psychopathol 2021; 50:577-589. [PMID: 34460050 DOI: 10.1007/s10802-021-00861-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/29/2022]
Abstract
Externalizing behaviors are associated with poor academic outcomes in community-based samples of children as young as preschool-age. However, there remains debate as to which specific externalizing dimensions link externalizing behaviors to early academic skills. Recently, research has supported the use of S-1 bifactor models to examine the hierarchical structure of externalizing behaviors and the unique relations between externalizing factors and academic impairment in samples of school-age children. The primary goals of this study were to extend the age range at which S-1 bifactor models are applied to externalizing behaviors and to determine if factors derived from an S-1 bifactor model had differing relations to early academic skills. In this study, the early academic skills of 1,356 preschool-age children (mean age = 49.98 months; SD = 8.08) were assessed, and preschool and childcare teachers rated children's externalizing behaviors. Results indicated that an S-1 bifactor model with a Hyperactive-Impulsive reference factor yielded the best-fitting model for preschool-age children's externalizing behaviors. Structural models revealed that both the Hyperactive-Impulsive reference factor and the Inattention factor uniquely predicted preschool children's early academic skills. The degree to which the results applied across the primary groups in the sample (i.e., White versus Black/African American children, girls versus boys) was examined for measurement and structural models.
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Affiliation(s)
- Eric D Hand
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, US.
| | - Christopher J Lonigan
- Department of Psychology and the Florida Center for Reading Research, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, US.
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15
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Eisenbarth H, Hart CM, Zechmeister J, Kudielka BM, Wüst S. Exploring the differential contribution of boldness, meanness, and disinhibition to explain externalising and internalising behaviours across genders. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02134-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Brislin SJ, Martz ME, Cope LM, Hardee JE, Weigard A, Heitzeg MM. Heterogeneity Within Youth With Childhood-Onset Conduct Disorder in the ABCD Study. Front Psychiatry 2021; 12:701199. [PMID: 34335337 PMCID: PMC8322519 DOI: 10.3389/fpsyt.2021.701199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine if personality traits can be used to characterize subgroups of youth diagnosed with childhood-onset conduct disorder (CD). Participants were 11,552 youth from the Adolescent Brain Cognitive Development study. Data used in this report came from doi: 10.15154/1504041 (M age 9.92; 45.3% female, 49.6% white, 19.0% Hispanic). A subset of this sample (n = 365) met criteria for CD. Latent profile analyses (LPA) were performed on this subgroup (n = 365) to define profiles of individuals with CD based on self-report measures of impulsivity, punishment sensitivity, reward response, and callous-unemotional traits. Follow up analyses determined if these groups differed on clinically relevant variables including psychopathology, environmental risk factors, social risk factors, and neurocognitive functioning. Participants with a CD diagnosis scored significantly higher on psychological, environmental, social, and neurocognitive risk factors. The LPA revealed three unique profiles, which differed significantly on liability for broad psychopathology and domain-specific liability for externalizing psychopathology but were largely matched on environmental and social risk factors. These unique configurations provide a useful way to further parse clinically relevant subgroups within youth who meet criteria for childhood-onset CD, setting the stage for prospective longitudinal research using these latent profiles to better understand the development of youth with childhood-onset CD.
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Affiliation(s)
- Sarah J. Brislin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Meghan E. Martz
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Lora M. Cope
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Jillian E. Hardee
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Alexander Weigard
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Mary M. Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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17
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Anker E, Ginsberg Y, Heir T. Prevalence of criminal convictions in Norwegian adult ADHD outpatients and associations with ADHD symptom severity and emotional dysregulation. BMC Psychiatry 2021; 21:226. [PMID: 33941124 PMCID: PMC8091664 DOI: 10.1186/s12888-021-03223-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Attention deficit hyperactivity disorder (ADHD) often co-occurs with antisocial behaviour. Several studies have shown high rates of ADHD among prisoners. However, the prevalence of crime among individuals with ADHD is less known. The aim of the present study was to estimate the prevalence of lifetime criminal conviction (CC) in a clinical sample of adults with ADHD, and the associations with the severity of ADHD and emotional dysregulation (ED). METHODS Patients were admitted to a private psychiatric outpatient clinic in Oslo between 2014 and 2018. Of the 656 patients diagnosed with ADHD, 629 (95.9%) agreed to participate in the study. CC was determined based on self-reporting of the lifetime history of criminal behaviour. ADHD was diagnosed according to the DSM-5 criteria, and ADHD severity was measured using the Adult ADHD Self-Report Scale (ASRS). ED was assessed by the eight-item version of Barkley's Current Behaviour Scale - Self-Report (CBS-SR). RESULTS The prevalence of self-reported CC in this clinical sample was 11.7% among women and 24.5% among men. CC was associated with hyperactive-impulsive severity (p < 0.001) and ED (p = 0.006). CONCLUSIONS The prevalence of self-reported lifetime criminal conviction was high for both genders. CC was associated with symptom severity of hyperactivity-impulsivity and emotional dysregulation. The findings suggest the need for greater research efforts on the avoidance of criminal activity in people with ADHD and targeted intervention for ADHD treatment and CC prevention.
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Affiliation(s)
- Espen Anker
- Oslo ADHD Clinic, Kirkeveien 64B, 0366, Oslo, Norway.
| | - Ylva Ginsberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
| | - Trond Heir
- University of Oslo, Institute of Clinical Medicine, Oslo, Norway
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18
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Buitelaar NJL, Posthumus JA, Bijlenga D, Buitelaar JK. The Impact of ADHD Treatment on Intimate Partner Violence in a Forensic Psychiatry Setting. J Atten Disord 2021; 25:1021-1031. [PMID: 31619111 DOI: 10.1177/1087054719879502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: The current longitudinal impact of treatment of ADHD on intimate partner violence (ITAP) study aims to investigate whether decrease of ADHD symptoms is associated with reduction of intimate partner violence (IPV) frequency in IPV offenders with ADHD in a forensic psychiatry setting. Method: Of n = 209 offenders of IPV with ADHD, frequency of IPV and ADHD symptoms were assessed at the 8th, 16th, 24th, and 52nd weeks of their combined treatment for ADHD and IPV. Results: We observed a significant decrease of self-reported ADHD symptoms (large effect size, d ≥ 0.80) and all IPV outcomes (small, d > 0.20, to large, d > 0.80, effect sizes). The decrease in IPV was mainly associated with the decrease in ADHD symptoms. Conclusion: As IPV treatment alone is not effective in the reduction of IPV in forensic psychiatry, we now have strong indications that the combined treatment of adult ADHD and IPV is more effective in offenders with ADHD.
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Affiliation(s)
- Nannet J L Buitelaar
- De Waag, De Forensische Zorgspecialisten, Utrecht, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Denise Bijlenga
- PsyQ Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
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19
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Heterogeneity and heterotypic continuity of emotional and behavioural profiles across development. Soc Psychiatry Psychiatr Epidemiol 2021; 56:807-819. [PMID: 32561937 DOI: 10.1007/s00127-020-01903-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/09/2020] [Indexed: 01/26/2023]
Abstract
PURPOSE To identify emotional and behavioural symptoms profiles from early childhood to adolescence, their stability across development and associated factors. METHODS Our sample included 17,216 children assessed at ages 3, 5, 7, 11 and 14 years from the UK Millennium Cohort Study. We used latent profile and latent transition analysis to study their emotional and behavioural profiles from early childhood to adolescence. We included sociodemographic, family and parenting variables to study the effect on latent profile membership and transitions. RESULTS The number and specific profiles of emotional and behavioural symptoms changed with the developmental stage. We found a higher number of profiles for ages 3, 5, and 14, suggesting greater heterogeneity in the presentation of emotional and behavioural symptoms in early childhood and adolescence compared to late childhood. There was greater heterotypic continuity between ages 3 and 5, particularly in transitions from higher to lower severity profiles. Children exposed to socioeconomic disadvantages were more likely to belong or transition to any moderate or high emotional and behavioural symptoms profiles. Maternal psychological distress and harsh parenting were associated with internalizing and externalizing profiles, respectively. Higher levels of internalizing and externalizing symptoms across development were associated with lower mental wellbeing and higher rates of self-harm and substance use in adolescence. CONCLUSION Emotional and behavioural symptoms develop early in life, with levels of heterogeneity and heterotypic stability that change throughout development. These results call for interventions to prevent and treat paediatric mental illness that consider the heterogeneity and stability of symptoms across development.
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20
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Chang CL, Liu TL, Hsiao RC, Yang P, Chen YL, Yen CF. Callous-Unemotional Traits among Adolescents with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, or Typical Development: Differences between Adolescents' and Parents' Views. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083972. [PMID: 33918812 PMCID: PMC8069479 DOI: 10.3390/ijerph18083972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/18/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022]
Abstract
This study examined parent-adolescent agreement on the callous, uncaring, and unemotional dimensions of callous-unemotional (CU) traits and the differences in adolescent-reported and parent-reported CU traits among 126 adolescents with autism spectrum disorder (ASD), 207 adolescents with attention-deficit/hyperactivity disorder (ADHD), and 203 typically developing (TD) adolescents. Adolescent-reported and parent-reported CU traits on the three dimensions of the Inventory of Callous and Unemotional Traits were obtained. The strength of CU traits and the differences between adolescent-reported and parent-reported traits were compared among the three groups using analysis of covariance. Parent-adolescent agreement was examined using intraclass correlation. The results reveal that both adolescent-reported and parent-reported callousness and uncaring traits in the ASD and ADHD groups were significantly stronger than those in the TD group. Parent-adolescent agreement on the uncaring trait was fair across the three groups, whereas that on callousness was poor across all three groups. Parent-adolescent agreement on unemotionality was fair in the TD group but poor in the ADHD and ASD groups. ASD and ADHD groups had significantly greater differences in scores reported by parents and adolescents on the callousness trait than the TD group. The parent-adolescent score differences in the uncaring trait were also larger in the ASD group than in the TD group. Thus, these results support the application of a multi-informant approach in CU trait assessment, especially for adolescents with ASD or ADHD.
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Affiliation(s)
- Chen-Lin Chang
- Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan;
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
| | - Tai-Ling Liu
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Ray C. Hsiao
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195-6560, USA;
- Department of Psychiatry, Children’s Hospital and Regional Medical Center, Seattle, WA 98105, USA
| | - Pinchen Yang
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan
- Department of Psychology, Asia University, Taichung 41354, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-2332-3456 (ext. 20106) (Y.-L.C.); +886-7-312-1101 (ext. 6822) (C.-F.Y.); Fax: +886-4-2332-1206 (Y.-L.C.); +886-7-313-4761 (C.-F.Y.)
| | - Cheng-Fang Yen
- School of Medicine, and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (T.-L.L.); (P.Y.)
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Correspondence: (Y.-L.C.); (C.-F.Y.); Tel.: +886-4-2332-3456 (ext. 20106) (Y.-L.C.); +886-7-312-1101 (ext. 6822) (C.-F.Y.); Fax: +886-4-2332-1206 (Y.-L.C.); +886-7-313-4761 (C.-F.Y.)
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21
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Aitken M, Andrade BF. Attention Problems and Restlessness as Transdiagnostic Markers of Severity and Treatment Response in Youth with Internalizing Problems. Res Child Adolesc Psychopathol 2021; 49:1069-1082. [PMID: 33755870 DOI: 10.1007/s10802-021-00797-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 11/25/2022]
Abstract
Transdiagnostic models of psychopathology suggest that disorders may share common features that could influence their severity. Attention problems and psychomotor restlessness are included in the diagnostic criteria for several disorders, including disorders on the internalizing spectrum, but their transdiagnostic significance has received little attention. The present study identifies patterns of attention problems and restlessness among youth with internalizing problems, in order to understand their clinical significance in terms of internalizing symptom severity and response to cognitive behavioral therapy (CBT). Participants were 142 adolescents age 11-18 clinically referred for mood and/or anxiety problems. Latent class analysis was used to identify patterns of self-reported attention problems and psychomotor restlessness, and classes were compared on internalizing, depression, and anxiety severity. Differences in treatment response were examined in a subset of youth (n = 82; age 14-18) who participated in group CBT. Youth in the Attention Problems class (42% of sample) and youth in the Restless class (15% of sample) endorsed significantly more internalizing, depression, and anxiety problems than youth with Low Symptoms of attention problems or psychomotor restlessness (43% of sample). Youth in the Restless class responded significantly better to CBT than youth in the Low Symptoms of attention problems or psychomotor restlessness class in terms of decrease in overall internalizing problems. Attention problems and psychomotor restlessness appear to be important transdiagnostic markers of severity across the internalizing spectrum; however, they do not limit the effectiveness of CBT and, in the case of psychomotor restlessness, may forecast a good treatment response.
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Affiliation(s)
- Madison Aitken
- Department of Psychiatry, University of Toronto, Toronto, Canada. .,Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada. .,Margaret and Wallace McCain Centre for Child and Youth Mental Health, Centre for Addiction and Mental Health, Toronto, Canada.
| | - Brendan F Andrade
- Department of Psychiatry, University of Toronto, Toronto, Canada.,Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Canada.,Margaret and Wallace McCain Centre for Child and Youth Mental Health, Centre for Addiction and Mental Health, Toronto, Canada
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22
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Vasconcelos M, Viding E, Sebastian CL, Faria S, Almeida PR, Gonçalves ÓF, Gonçalves RA, Sampaio A, Seara-Cardoso A. Callous-Unemotional Traits Moderate Anticipated Guilt and Wrongness Judgments to Everyday Moral Transgressions in Adolescents. Front Psychiatry 2021; 12:625328. [PMID: 33762977 PMCID: PMC7982950 DOI: 10.3389/fpsyt.2021.625328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/09/2021] [Indexed: 12/17/2022] Open
Abstract
Callous-unemotional (CU) traits observed during childhood and adolescence are thought to be precursors of psychopathic traits in adulthood. Adults with high levels of psychopathic traits typically present antisocial behavior. Such behavior can be indicative of atypical moral processing. Evidence suggests that moral dysfunction in these individuals may stem from a disruption of affective components of moral processing rather than from an inability to compute moral judgments per se. No study to date has tested if the dissociation between affective and cognitive dimensions of moral processing linked to psychopathic traits in adulthood is also linked to CU traits during development. Here, 47 typically developing adolescents with varying levels of CU traits completed a novel, animated cartoon task depicting everyday moral transgressions and indicated how they would feel in such situations and how morally wrong the situations were. Adolescents with higher CU traits reported reduced anticipated guilt and wrongness appraisals of the transgressions. However, our key finding was a significant interaction between CU traits and anticipated guilt in predicting wrongness judgments. The strength of the association between anticipated guilt and wrongness judgement was significantly weaker for those with higher levels of CU traits. This evidence extends our knowledge on the cognitive-affective processing deficits that may underlie moral dysfunction in youth who are at heightened risk for antisocial behavior and psychopathy in adulthood. Future longitudinal research is required to elucidate whether there is an increased dissociation between different components of moral processing from adolescence to adulthood for those with high psychopathic traits.
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Affiliation(s)
- Margarida Vasconcelos
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Essi Viding
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | | | - Susana Faria
- Department of Mathematics, University of Minho, Braga, Portugal
| | - Pedro R. Almeida
- Faculty of Law, Interdisciplinary Research Centre on Crime Justice and Security, School of Criminology, University of Porto, Porto, Portugal
| | - Óscar F. Gonçalves
- Proaction Laboratory, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Rui A. Gonçalves
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- School of Psychology, Campus de Gualtar, University of Minho, Braga, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Seara-Cardoso
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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23
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Johnston OG, Cruess DG, Burke JD. Irritability and Behavioral Symptom Dimensions of Oppositional Defiant Disorder in Young Adults: Associations with DSM-5 Pathological Personality Traits. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2020. [DOI: 10.1007/s10862-020-09786-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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The Associations between Callous-unemotional Traits and Symptoms of Conduct Problems, Hyperactivity and Emotional Problems: A Study of Adolescent Twins Screened for Neurodevelopmental Problems. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:447-457. [PMID: 29728890 PMCID: PMC6397133 DOI: 10.1007/s10802-018-0439-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Callous-unemotional (CU) traits (e.g., lack of empathy, lack of guilt, shallow affect) are associated with severe and persistent conduct problems in youth. There is evidence showing a substantial genetic correlation between CU traits and conduct problems. The etiological associations between CU traits and other psychopathological symptoms, including symptoms of hyperactivity and emotional problems (such as anxiety and depression symptoms), have been less explored. To examine the etiological associations between CU traits and symptoms of conduct problems, hyperactivity and emotional problems separately through the use of a twin design. Participants were same-sex twin pairs (n = 426 twins; 42% female; 43% MZ; age = 15) drawn from the Child and Adolescents Twin Study in Sweden, a longitudinal study of twins born in Sweden. The sample was mainly composed of children who screenpositive on neurodevelopmental problems/mental health problems or at-risk children (i.e., screen-negative children considered to be genetically at-risk siblings). We used self-report measures of CU traits, conduct problems, hyperactivity and emotional problems. Model-fitting analyses were conducted using structural equation modeling. We found a strong positive genetic correlation between CU traits and conduct problems and a moderate genetic correlation between CU traits and hyperactivity. We also found a relatively modest, but significant negative genetic correlation between CU traits and emotional problems. Using a sample of adolescent twins screened for neurodevelopmental problems, we replicated previous findings that showed a strong genetic correlation between CU traits and conduct problems and we extended research by examining further the etiological associations between CU traits and symptoms of hyperactivity and emotional problems.
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25
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Buitelaar NJL, Posthumus JA, Buitelaar JK. ADHD in Childhood and/or Adulthood as a Risk Factor for Domestic Violence or Intimate Partner Violence: A Systematic Review. J Atten Disord 2020; 24:1203-1214. [PMID: 25995243 DOI: 10.1177/1087054715587099] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To date, treatment programs for adult domestic violence (DV) or intimate partner violence (IPV) have had minimal impact. To make treatment more effective, programs should be adjusted to psychopathology of the offender. As emotional lability and poor emotional self-regulation and self-control are common features of ADHD, it may play a pivotal role as a predictor for adult DV/IPV. Method: This systematic review synthesizes the available evidence for childhood and/or adult ADHD being a risk factor for DV/IPV. Results: Four case control studies and three cohort studies were included in the review. Although three case control studies showed positive associations between childhood and/or adult ADHD and adult DV/IPV, two did insufficiently control for the presence of comorbid Conduct Disorder (CD) or Antisocial Personality Disorder (ASPD). Conclusion: Cohort studies identified hyperactive, impulsive, and inattention symptoms as risk factors for adult IPV. CD and ASPD were regarded as mediators in three studies.
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Affiliation(s)
- Nannet J L Buitelaar
- De Forensische Zorgspecialisten, Utrecht, The Netherlands.,Radboud University Nijmegen, The Netherlands
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26
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Adolescent-Parent Agreement on Callous-Unemotional Traits in Adolescents with Attention-Deficit/Hyperactivity Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113888. [PMID: 32486294 PMCID: PMC7312037 DOI: 10.3390/ijerph17113888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 01/27/2023]
Abstract
This study examined the levels of agreement between the reports of 207 adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents regarding the adolescents' callous-unemotional (CU) traits and investigated the factors influencing adolescent-parent agreement. Adolescent-parent agreement about CU traits in three dimensions according to the Chinese version of the Inventory of Callous and Unemotional Traits was examined. The influence of demographic characteristics, comorbid conduct disorder (CD), oppositional defiant disorder (ODD), and ADHD symptoms on adolescent-parent agreement was also examined. The results indicated that adolescent-parent agreement on the CU trait of uncaringness was moderate, whereas agreement on the CU traits of callousness and unemotionality was poor. Adolescent-parent agreement on the three dimensions of CU traits varied depending on the adolescents' sex and comorbid CD and ODD symptoms as well as parental age. Therefore, multiple sources of information are required when assessing the severity of CU traits in adolescents with ADHD. The factors influencing the levels of the agreement should also be considered.
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27
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Galán CA, Wang FL, Shaw DS, Forbes EE. Early Childhood Trajectories of Conduct Problems and Hyperactivity/Attention Problems: Predicting Adolescent and Adult Antisocial Behavior and Internalizing Problems. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2020; 49:200-214. [PMID: 30702950 PMCID: PMC6669117 DOI: 10.1080/15374416.2018.1534206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although conduct problems (CP) and hyperactivity/attention problems (HAP) are thought to covary with regularity, few studies have traced the probability of co-occurring CP and HAP longitudinally, particularly beginning in the toddler period. Further, there is little research examining how early co-occurring trajectories of CP and HAP predict functioning across several domains through late adolescence and early adulthood. Using a cohort of 284 low-income boys, we examined whether separate developmental trajectories of overt CP and HAP symptomatology from ages 2 to 10 relate to violent behavior, established correlates of antisocial behavior, impulsivity, and internalizing problems in adolescence and early adulthood. Co-occurring trajectory patterns of CP and HAP from ages 2 to 10 were also investigated in relation to later maladjustment. Findings indicated that trajectories of CP beginning in early childhood were related to violent behavior in adolescence and adulthood, adolescent correlates of antisocial behavior (i.e., deviant talk with peers), and internalizing problems in adulthood. Early HAP trajectories were also related to later problem behaviors when considered in isolation. However, when examining trajectories of CP and HAP simultaneously, children with chronic CP + chronic HAP, but not HAP-only, were most at risk for multiple types of problem behaviors in adolescence and early adulthood, including violent behavior and depressive and anxiety symptoms. Thus, HAP symptomatology was no longer predictive of adolescent and adult functioning once co-occurring CP was accounted for. Findings extend prior research with older children of HAP and/or CP, highlighting the predictive value of trajectories of CP beginning in the toddler period.
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28
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Vetter NC, Backhausen LL, Buse J, Roessner V, Smolka MN. Altered brain morphology in boys with attention deficit hyperactivity disorder with and without comorbid conduct disorder/oppositional defiant disorder. Hum Brain Mapp 2020; 41:973-983. [PMID: 31691449 PMCID: PMC7267962 DOI: 10.1002/hbm.24853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 10/15/2019] [Accepted: 10/21/2019] [Indexed: 01/01/2023] Open
Abstract
About 50% of attention deficit hyperactivity disorder (ADHD) patients suffer from comorbidity with oppositional defiant disorder/conduct disorder (ODD/CD). Most previous studies on structural morphology did not differentiate between pure (ADHD-only) and comorbid ADHD (ADHD+ODD/CD). Therefore, we aimed to investigate the structural profile of ADHD-only versus ADHD+ODD/CD spanning the indices subcortical and cortical volume, cortical thickness, and surface area. We predicted a reduced total gray matter, striatal, and cerebellar volume in both patient groups and a reduced amygdalar and hippocampal volume for ADHD+ODD/CD. We also explored alterations in prefrontal volume, thickness, and surface area. We acquired structural images from an adolescent sample ranging from 11 to 17 years, matched with regard to age, pubertal status, and IQ-including 36 boys with ADHD-only, 26 boys with ADHD+ODD/CD, and 30 typically developing (TD) boys. We analyzed structural data with FreeSurfer. We found reductions in total gray matter and total surface area for both patient groups. Boys with ADHD+ODD/CD had a thicker cortex than the other groups in a right rostral middle frontal cluster, which was related to stronger ODD/CD symptoms, even when controlling for ADHD symptoms. No group differences in local cortical volume or surface area emerged. We demonstrate the necessity to carefully differentiate between ADHD and ADHD+ODD/CD. The increased rostral middle frontal thickness might hint at a delayed adolescent cortical thinning in ADHD+ODD/CD. Patients with the double burden ADHD and ODD or CD seem to be even more affected than patients with pure ADHD.
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Affiliation(s)
- Nora C. Vetter
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the Technische Universität DresdenDresdenGermany
| | - Lea L. Backhausen
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the Technische Universität DresdenDresdenGermany
| | - Judith Buse
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the Technische Universität DresdenDresdenGermany
| | - Veit Roessner
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the Technische Universität DresdenDresdenGermany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
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29
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Szabó E, Halász J, Morgan A, Demetrovics Z, Kökönyei G. Callous-unemotional traits and the attentional bias towards emotional stimuli: Testing the moderating role of emotional and behavioural problems among high-risk adolescents. Clin Child Psychol Psychiatry 2020; 25:156-173. [PMID: 30648434 DOI: 10.1177/1359104518822690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Former studies demonstrated that antisocial youth with callous-unemotional (CU) traits are impaired in the processing of negative emotional stimuli. The aim of the current study was to explore the moderating role of different behavioural (i.e. conduct problems, hyperactivity-inattention) and emotional problems (i.e. internalizing symptoms) in the relationship between CU traits and attentional bias towards emotional stimuli. Besides using self-report measures, attentional bias was tested by an affective dot-probe task in a high-risk sample of 102 adolescent boys (M age = 16.34 years; SD = 1.32). CU traits were related to reduced attention to emotionally distressing pictures. Furthermore, conduct problems significantly moderated the relationship between CU traits and attention to distress cues. These findings highlight the importance of considering potential moderators to the well-established link between CU traits and deficits in response to negative emotional cues.
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Affiliation(s)
- Edina Szabó
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Hungary.,Institute of Psychology, ELTE Eötvös Loránd University, Hungary.,MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Hungary
| | - József Halász
- Vadaskert Child Psychiatry Hospital, Hungary.,Alba Regia University Centre, Óbuda University, Hungary
| | - Antony Morgan
- School of Health and Life Sciences, Glasgow Caledonian University, UK
| | | | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Hungary.,SE-NAP 2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Hungary.,Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Hungary
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30
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Déry M, Bégin V, Toupin J, Temcheff C. Clinical Utility of the Limited Prosocial Emotions Specifier in the Childhood-Onset Subtype of Conduct Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:838-845. [PMID: 31694398 PMCID: PMC7003113 DOI: 10.1177/0706743719885469] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Clinicians may specify the diagnosis of conduct disorder (CD) as "with limited prosocial emotions" (LPE). This specifier is thought to identify youths with particularly severe and stable symptomatology. However, few studies have examined the clinical usefulness of the LPE specifier among children with childhood-onset CD. The current study examines whether the LPE specifier distinguishes children with particularly severe and persistent symptoms among those with childhood-onset CD. The study also aims to test whether the LPE specifier aids in identifying children with subclinical CD whose conduct problems are at risk of increasing. METHOD Two hundred sixty-four children showing at least one CD symptom before age 10 were divided based on the presence of CD and the specifier. Children with and without the specifier were compared on number of CD symptoms (assessed at study inception) and trajectory of conduct problems (assessed over 4 years). The analyses controlled for oppositional defiant and attention deficit hyperactivity symptomatology. RESULTS Compared with children with CD but without LPE, children with CD and the LPE specifier did not differ on likelihood of endorsing most symptoms nor on total numbers of symptoms. Moreover, they did not show a more stable pattern of conduct problems across the 4 years. Children with subclinical CD with and without the LPE specifier were also similar in terms of their symptoms, severity, and evolution of their problems. CONCLUSIONS Among youths with childhood-onset CD, the specifier appears to offer limited value in identifying those with particularly severe and stable CD symptomatology.
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Affiliation(s)
- Michèle Déry
- Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Vincent Bégin
- Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean Toupin
- Université de Sherbrooke, Sherbrooke, Quebec, Canada
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31
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Wright N, Pickles A, Braithwaite EC, Sharp H, Hill J. Sex-dependent associations between maternal prenatal cortisol and child callous-unemotional traits: Findings from the Wirral Child Health and Development Study. Psychoneuroendocrinology 2019; 109:104409. [PMID: 31446327 PMCID: PMC6857434 DOI: 10.1016/j.psyneuen.2019.104409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/12/2019] [Accepted: 08/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Elevated maternal glucocorticoids during pregnancy may impact on fetal development in a sex-dependent way, leading to increased amygdala activation and increased risk for internalising disorders in females. Based on evidence implicating reduced amygdala activation in callous-unemotional (CU) traits, we predicted that elevated maternal cortisol in pregnancy would be associated with lower CU traits and elevated anxious-depressed symptoms, only in girls. METHODS Participants were 225 members of a stratified subsample within an epidemiological longitudinal cohort (WCHADS). Salivary cortisol was measured over two days at 32 weeks gestation (on waking, 30-min post-waking and during the evening) and the log of the area under the curve (LogAUC) was calculated as an index of diurnal cortisol. Mothers reported on child CU traits and anxious-depressed symptoms at 2.5, 3.5 and 5.0 years of age. RESULTS As predicted there was a sex of child by cortisol interaction (p < .001) whereby elevated maternal cortisol was associated with lower child CU traits, explaining 25% of the variance, in girls, but not in boys. This effect remained when controlling for relevant confounders and anxious-depressed symptoms. By contrast, elevated maternal cortisol did not predict higher anxious-depressed symptoms in girls. CONCLUSIONS The study adds to growing evidence for sex-dependent effects of elevated maternal cortisol during pregnancy on early child psychopathology, consistent with mediation by elevated amygdala activation. The conditions under which, in girls, this is associated with heightened responsiveness to others' distress characteristic of low CU traits, or with increased affective symptoms, require further study.
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Affiliation(s)
- Nicola Wright
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
| | | | - Helen Sharp
- Department of Psychological Sciences, Institute of Life and Human Sciences, Liverpool, UK.
| | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.
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32
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Kliem S, Lohmann A, Neumann M, Glaubitz C, Haselbach S, Bergmann MC, Baier D. Factor Structure of the Inventory of Callous-Unemotional Traits in a Representative Sample of German 9th Grade Students. Res Child Adolesc Psychopathol 2019; 48:43-55. [PMID: 31642027 DOI: 10.1007/s10802-019-00590-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Callous-unemotional (CU) traits represent the affective components of the psychopathy construct and show a strong relationship to violence and conduct-disorder in children. The Inventory of Callous-Unemotional Traits (ICU) is the current standard to assess CU traits. Despite the ICU having originally been constructed as a four-dimensional instrument, several studies found a three-factorial structure in combination with a general ICU-factor to be the best fitting factor-model. An imbalance in the number of positively and negatively worded items can be observed between the identified ICU dimensions. To investigate the effect of item keying on the factor structure we tested different factor-models in data stemming from a large sample (N = 3878) of German ninth grade students. Our findings suggest that the original four-factorial structure with a method factor shows good model fit. This solution is furthermore in line with the specifiers of the additional coding of Limited Prosocial Emotions for Conduct Disorder in the DSM-V.
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Affiliation(s)
- Sören Kliem
- Criminological Research Institute of Lower Saxony, Hannover, Germany. .,Ernst-Abbe-Hochschule Jena, University of Applied Sciences, Jena, Germany.
| | - Anna Lohmann
- Criminological Research Institute of Lower Saxony, Hannover, Germany
| | - Merten Neumann
- Criminological Research Institute of Lower Saxony, Hannover, Germany
| | | | | | | | - Dirk Baier
- Zurich University of Applied Sciences, Winterthur, Switzerland
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33
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Evans SC, Cooley JL, Blossom JB, Pederson CA, Tampke EC, Fite PJ. Examining ODD/ADHD Symptom Dimensions as Predictors of Social, Emotional, and Academic Trajectories in Middle Childhood. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:912-929. [PMID: 31454272 DOI: 10.1080/15374416.2019.1644645] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The goal of this article is to investigate the symptom dimensions of oppositional defiant disorder (ODD; irritability, defiance) and attention deficit/hyperactivity disorder (ADHD; inattention, hyperactivity-impulsivity) as predictors of academic performance, depressive symptoms, and peer functioning in middle childhood. Children (N = 346; 51% female) were assessed via teacher-report on measures of ODD/ADHD symptoms at baseline (Grades K-2) and academic performance, depressive symptoms, peer rejection, and victimization on 7 occasions over 4 school years (K-2 through 3-5). Self-report and grade point average data collected in Grades 3-5 served as converging outcome measures. Latent growth curve and multiple regression models were estimated using a hierarchical/sensitivity approach to assess robustness and specificity of effects. Irritability predicted higher baseline depressive symptoms, peer rejection, and victimization, whereas defiance predicted higher baseline peer rejection; however, none of these ODD-related effects persisted 3 years later to Grades 3-5. In contrast, inattention predicted persistently poorer academic performance, persistently higher depressive symptoms, and higher baseline victimization; hyperactivity-impulsivity predicted subsequent peer rejection and victimization in Grades 3-5. In converging models, only inattention emerged as a robust predictor of 3-year outcomes (viz., grade point average, depressive symptoms, peer rejection, and relational victimization). Broadly, ODD dimensions-particularly irritability-may be linked to acute disturbances in social-emotional functioning in school-age children, whereas ADHD dimensions may predict more persistent patterns of peer, affective, and academic problems. By examining all 4 ODD/ADHD symptom dimensions simultaneously, the present analyses offer clarity and specificity regarding which dimensions affect what outcomes, and when. Findings underscore the importance of multidimensional approaches to research, assessment, and intervention.
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Affiliation(s)
| | - John L Cooley
- Developmental Psychobiology Research Group, Department of Psychiatry, University of Colorado Anschutz Medical Campus
| | - Jennifer B Blossom
- Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | | | | | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas
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34
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Young AS, Youngstrom EA, Findling RL, Van Eck K, Kaplin D, Youngstrom JK, Calabrese J, Stepanova E, The Lams Consortium. Developing and Validating a Definition of Impulsive/Reactive Aggression in Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2019; 49:787-803. [PMID: 31343896 DOI: 10.1080/15374416.2019.1622121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The goal of this study is to develop a rational data-driven definition of impulsive/reactive aggression and establish distinctions between impulsive/reactive aggression and other common childhood problems. This is a secondary analysis of data from Assessing Bipolar: A Community Academic Blend (ABACAB; N = 636, ages 5-18), Stanley Medical Research Institute N = 392, ages 5-17), and the Longitudinal Assessment of Manic Symptoms (LAMS; N = 679, ages 6-12) studies, which recruited youths seeking outpatient mental health services in academic medical centers and community clinics. Following Jensen et al.'s (2007) procedure, 3 judges independently rated items from several widely used scales in terms of assessing impulsive/reactive aggression. Principal components analyses (PCA) modeled structure of the selected items supplemented by items related to mood symptoms, rule-breaking behavior, and hyperactivity/impulsivity to better define the boundaries between impulsive/reactive aggression and other common childhood symptoms. In the rational item selection process, there was good agreement among the 3 experts who rated items as characterizing impulsive/reactive aggression or not. PCA favored 5 dimension solutions in all 3 samples. Across all samples, PCA resulted in rule-breaking behavior, aggression-impulsive/reactive (AIR), mania, and depression dimensions; there was an additional hyperactive/impulsive dimension in the LAMS sample and a self-harm dimension in ABACAB and Stanley samples. The dimensions demonstrated good internal consistency; criterion validity coefficients also showed consistency across samples. This study is a step toward developing an empirically derived nosology of impulsive aggression/AIR. Findings support the validity of the AIR construct, which can be distinguished from manic and depressive symptoms as well as rule-breaking behavior.
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Affiliation(s)
- Andrea S Young
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Robert L Findling
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Kathryn Van Eck
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Dana Kaplin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
| | - Jennifer K Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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Milledge SV, Cortese S, Thompson M, McEwan F, Rolt M, Meyer B, Sonuga-Barke E, Eisenbarth H. Peer relationships and prosocial behaviour differences across disruptive behaviours. Eur Child Adolesc Psychiatry 2019; 28:781-793. [PMID: 30387006 DOI: 10.1007/s00787-018-1249-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/27/2018] [Indexed: 12/28/2022]
Abstract
It is unclear if impairments in social functioning and peer relationships significantly differ across common developmental conditions such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder (CD), and associated callous-unemotional traits (CU traits). The current study explored sex differences and symptoms of parent- and teacher-reported psychopathology on peer relationships and prosocial behaviour in a sample of 147 referred children and adolescents (aged 5-17 years; 120 m). The results showed that increases in parent-reported ADHD Inattentive symptoms and teacher-reported ADHD Hyperactive-Impulsive symptoms, CD, ODD, and CU traits were significantly associated with peer relationship problems across sex. At the same time, teacher-reported symptoms of ODD and both parent- and teacher-reported CU traits were related to difficulties with prosocial behaviour, for both boys and girls, with sex explaining additional variance. Overall, our findings show a differential association of the most common disruptive behaviours to deficits in peer relationships and prosocial behaviour. Moreover, they highlight that different perspectives of behaviour from parents and teachers should be taken into account when assessing social outcomes in disruptive behaviours. Given the questionable separation of conduct problem-related constructs, our findings not only point out the different contribution of those aspects in explaining peer relationships and prosocial behaviour, but furthermore the variance from different informants about those aspects of conduct problems.
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Affiliation(s)
- Sara V Milledge
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Samuele Cortese
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Margaret Thompson
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Fiona McEwan
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Michael Rolt
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Brenda Meyer
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, Kings College, London, SE5 9RJ, UK
| | - Hedwig Eisenbarth
- Department of Psychology, University of Southampton, Southampton, SO17 1BJ, UK. .,School of Psychology, Victoria University of Wellington, Wellington, 6011, New Zealand.
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36
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Empathy in Youths with Conduct Disorder and Callous-Unemotional Traits. Neural Plast 2019; 2019:9638973. [PMID: 31097957 PMCID: PMC6487083 DOI: 10.1155/2019/9638973] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 03/03/2019] [Indexed: 12/19/2022] Open
Abstract
Previous studies indicated that a lack of empathy could be considered the core feature of callous-unemotional (CU) traits in children and adolescents. The present study is aimed at exploring relationships among CU traits, cognitive and emotional dimensions of empathy, emotion recognition (basic, social, and complex emotions), and history of maltreatment in a sample of youths with conduct disorder diagnosis. The sample consisted of 60 Italian male patients (age range 11-17 years, mean age 13.27 ± 1.90 years) referred to the Department of Child and Adolescent Psychiatry (Pisa, Italy). In the whole sample, the levels of CU traits were significantly negatively associated with both cognitive and emotional dimensions of empathy; in addition, the CD patients with high levels of CU traits show significantly lower levels of empathic concern compared to those with low levels of CU traits. Clinical implications of the findings are discussed.
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Kim H, Chang H. Longitudinal Association Between Children's Callous-Unemotional Traits and Social Competence: Child Executive Function and Maternal Warmth as Moderators. Front Psychol 2019; 10:379. [PMID: 30873083 PMCID: PMC6403163 DOI: 10.3389/fpsyg.2019.00379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/07/2019] [Indexed: 12/21/2022] Open
Abstract
This study examined the longitudinal association between children's early callous-unemotional (CU) traits and social competence in the transition to school-age, and tested whether this relationship was moderated by child executive function and maternal warmth. Participants were 643 children (49% girls) who were part of the Panel Study on Korean Children (PSKC) of the Korea Institute of Child Care and Education (KICCE). Mothers rated children's CU at 5 years and executive function at 8 years, and maternal warmth at 5 years. Teachers reported on children's social competence at 8 years. Results of the model including child executive function as the moderator indicated that deficits in child executive function and child sex (boys) predicted lower social competence. In addition, the moderating effect of executive function on the relationship between CU and social competence approached a trend such that CU predicted lower social competence only for children with lower executive function. In the model that included maternal warmth as a moderator, CU traits was associated with lower social competence, and this effect was more pronounced for boys as indicated by a significant effects of CU × child sex on social competence. The findings are discussed with respect to considering individual and contextual factors by which early CU becomes associated with individual differences in children's social competence.
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Affiliation(s)
| | - Hyein Chang
- Department of Psychology, Sungkyunkwan University, Seoul, South Korea
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McAloon J, Lazarou KD. Preventative Intervention for Social, Emotional and Behavioural Difficulties in Toddlers and Their Families: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040569. [PMID: 30781463 PMCID: PMC6406496 DOI: 10.3390/ijerph16040569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 12/01/2022]
Abstract
Preventative intervention early in life is key to interrupting trajectories toward subsequent emotional and behavioural problems later in life. This study examined the effectiveness of the Holding Hands program, an innovative program of preventative intervention aimed at improving the behavioural and emotional functioning of 12 to 48-month-old toddlers, and the wellbeing of their parents. This program seeks to synthesise the existing evidence in four ways; it incorporates both traditional Parent Management Training and Direct Coaching methods. It is intensive, significantly reducing session numbers and it explicitly addresses parental emotion regulation. The program also utilises operant learning principals in an effort to contingently reinforce behaviour that parents want to see more of, without employing exclusionary strategies in response to behavior that parents want to see less of. Thirty-one families, with a toddler who met clinical or sub-clinical cut-offs for externalising or internalising problems, were self- or externally-referred to the six- to eight-week program. Results indicated statistically significant improvement in toddler emotional and behavioural functioning, and parent well-being on a range of psychometric measures from pre- to post-treatment. Treatment gains were maintained for parents and children at follow-up. Implications of these findings for clinical practice and suggestions for future research are discussed.
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Affiliation(s)
- John McAloon
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.
| | - Karina D Lazarou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.
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Predicting Youth Improvement in Community-Based Residential Settings with Practices Derived from the Evidence-Base. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2019; 46:458-473. [PMID: 30767101 DOI: 10.1007/s10488-019-00925-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The current investigation conducted descriptive analyses on key variables in community-based residential (CBR) settings and investigated the extent to which disruptive youth between the ages of 13 and 17 years improved based on therapists' reported alignment with using practices derived from the evidence-base (PDEBs). Results from both the descriptive analyses and multilevel modeling suggested that therapists are using practices that both do and do not align with the evidence-base for disruptive youth. In addition, both PDEBs and practices with minimal evidence-support predicted or marginally predicted final average progress rating for these youth. Findings are discussed as they relate to the importance of continued exploration of treatment outcomes for CBR youth.
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Te Brinke LW, Schuiringa HD, Menting ATA, Deković M, de Castro BO. A cognitive versus behavioral approach to emotion regulation training for externalizing behavior problems in adolescence: Study protocol of a randomized controlled trial. BMC Psychol 2018; 6:49. [PMID: 30305174 PMCID: PMC6180356 DOI: 10.1186/s40359-018-0261-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 09/20/2018] [Indexed: 12/19/2022] Open
Abstract
Background Interventions for adolescents with externalizing behavior problems are generally found to be only moderately effective, and treatment responsiveness is variable. Therefore, this study aims to increase intervention effectiveness by examining effective approaches to train emotion regulation, which is considered to be a crucial mechanism involved in the development of externalizing behavior problems. Specifically, we aim to disentangle a cognitive and behavioral approach to emotion regulation training. Methods A randomized controlled parallel-group study with two arms will be used. Participants are adolescents between 12 and 16 years old, with elevated levels of externalizing behavior problems. Participants will be randomly assigned to either the control condition or the intervention condition. Participants in the intervention condition receive both a cognitive and behavioral emotion regulation module, but in different sequences. Primary outcome measures are emotion regulation skills, emotion regulation strategies, and externalizing behavior problems. Questionnaires will be completed at pre-test, in-between modules, and post-test. Moreover, intensive longitudinal data is collected, as adolescents will complete weekly and daily measures. Discussion Gaining insight into which approaches to emotion regulation training are more effective, and for whom, is important because it may lead to the adaptation of effective intervention programs for adolescents with externalizing behavior problems. Eventually, this could lead to individually tailored evidence-based interventions. Trial registration The trial is registered at the Central Committee on Research Involving Human Subjects (NL61104.041.17, September 20th, 2017) and the Dutch Trial Register (NTR7334, July 10th, 2018).
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Affiliation(s)
- L W Te Brinke
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands. .,Utrecht University, PO BOX 80140, 3508, TC, Utrecht, The Netherlands.
| | - H D Schuiringa
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands
| | - A T A Menting
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands
| | - M Deković
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands
| | - B O de Castro
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, The Netherlands
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Pardini DA, Byrd AL, Hawes SW, Docherty M. Unique Dispositional Precursors to Early-Onset Conduct Problems and Criminal Offending in Adulthood. J Am Acad Child Adolesc Psychiatry 2018; 57:583-592.e3. [PMID: 30071979 PMCID: PMC7045361 DOI: 10.1016/j.jaac.2018.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 04/13/2018] [Accepted: 06/11/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aims of this study were to examine whether dispositional interpersonal callousness, negative emotionality, and hyperactivity/impulsivity uniquely influence the development of childhood-onset conduct problems and persistent criminal behavior in males, and to determine whether specific facets of negative emotionality (dysregulated anger versus anxiety) in childhood are differentially associated with the development of chronic antisocial behavior. METHOD Childhood dispositional features and conduct problems were assessed semiannually using parent- and teacher-report measures across 9 consecutive assessments in a school-based sample of 503 boys (∼7-11 years of age). Participants' criminal behavior was assessed using official records from adolescence into the early 30s. RESULTS Interpersonal callousness, dysregulated anger, and hyperactivity/impulsivity were uniquely associated with the development of childhood-onset conduct problems. None of these features significantly predicted official records of juvenile offending after controlling for co- occurring conduct problems. However, interpersonal callousness was robustly and uniquely associated with a pattern of persistent and violent adult offending that continued into the early 30s. In contrast, anxiety problems were inversely associated with criminal offending in adolescence and adulthood after controlling for conduct problems and the other dispositional factors. CONCLUSION Findings are consistent with theoretical models indicating that interpersonal callousness, dysregulated anger, and hyperactivity/impulsivity influence the development of childhood conduct problems. In contrast, anxiety problems in childhood tend to reduce the likelihood that boys will engage in later criminal offending. Results suggest that delinquency prevention programs should target children exhibiting features of interpersonal callousness, given that they are at high risk for engaging in chronic and violent offending in adulthood.
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Affiliation(s)
| | - Amy L. Byrd
- University of Pittsburgh School of Medicine, PA
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Cardinale EM, Breeden AL, Robertson EL, Lozier LM, Vanmeter JW, Marsh AA. Externalizing behavior severity in youths with callous-unemotional traits corresponds to patterns of amygdala activity and connectivity during judgments of causing fear. Dev Psychopathol 2018; 30:191-201. [PMID: 28535830 PMCID: PMC7055507 DOI: 10.1017/s0954579417000566] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Callous-unemotional (CU) traits characterize a subgroup of youths with conduct problems who exhibit low empathy, fearlessness, and elevated externalizing behaviors. The current study examines the role of aberrant amygdala activity and functional connectivity during a socioemotional judgment task in youths with CU traits, and links these deficits to externalizing behaviors. Functional magnetic resonance imaging was used to compare neural responses in 18 healthy youths and 30 youths with conduct problems and varying levels of CU traits as they evaluated the acceptability of causing another person to experience each of several emotions, including fear. Neuroimaging analyses examined blood oxygenation level dependent responses and task-dependent functional connectivity. High-CU youths exhibited left amygdala hypoactivation relative to healthy controls and low-CU youths primarily during evaluations of causing others fear. CU traits moderated the relationship between externalizing behavior and both amygdala activity and patterns of functional connectivity. The present data suggest that CU youths' aberrant amygdala activity and connectivity affect how they make judgments about the acceptability of causing others emotional distress, and that these aberrations represent risk factors for externalizing behaviors like rule breaking and aggression. These findings suggest that reducing externalizing behaviors in high-CU youths may require interventions that influence affective sensitivity.
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Raschle NM, Menks WM, Fehlbaum LV, Steppan M, Smaragdi A, Gonzalez-Madruga K, Rogers J, Clanton R, Kohls G, Martinelli A, Bernhard A, Konrad K, Herpertz-Dahlmann B, Freitag CM, Fairchild G, De Brito SA, Stadler C. Callous-unemotional traits and brain structure: Sex-specific effects in anterior insula of typically-developing youths. NEUROIMAGE-CLINICAL 2017. [PMID: 29527490 PMCID: PMC5842751 DOI: 10.1016/j.nicl.2017.12.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Callous-unemotional traits are characterized by a lack of empathy, a disregard for others' feelings and shallow or deficient affect, such as a lack of remorse or guilt. Neuroanatomical correlates of callous-unemotional traits have been demonstrated in clinical samples (i.e., adolescents with disruptive behavior disorders). However, it is unknown whether callous-unemotional traits are associated with neuroanatomical correlates within normative populations without clinical levels of aggression or antisocial behavior. Here we investigated the relationship between callous-unemotional traits and gray matter volume using voxel-based morphometry in a large sample of typically-developing boys and girls (N = 189). Whole-brain multiple regression analyses controlling for site, total intracranial volume, and age were conducted in the whole sample and in boys and girls individually. Results revealed that sex and callous-unemotional traits interacted to predict gray matter volume when considering the whole sample. This interaction was driven by a significant positive correlation between callous-unemotional traits and bilateral anterior insula volume in boys, but not girls. Insula gray matter volume explained 19% of the variance in callous-unemotional traits for boys. Our results demonstrate that callous-unemotional traits are related to variations in brain structure beyond psychiatric samples. This association was observed for boys only, underlining the importance of considering sex as a factor in future research designs. Future longitudinal studies should determine whether these findings hold over childhood and adolescence, and whether the neuroanatomical correlates of callous-unemotional traits are predictive of future psychiatric vulnerability. General scientific summary This study suggests that callous-unemotional traits have a neuroanatomical correlate within typically developing boys, but not girls. Bilateral anterior insula volume explains up to 19% of the variance in callous-unemotional traits in boys. Sex-specific correlations between callous-unemotional (CU) traits and insula volume. CU-traits are positively linked to anterior insula in typically-developing boys. Variations in insula volume explained 19% of the variance in CU-traits in boys. Accounting for sex in neuroanatomical studies of individual differences is important.
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Affiliation(s)
- Nora Maria Raschle
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland.
| | - Willeke Martine Menks
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Lynn Valérie Fehlbaum
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Martin Steppan
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
| | - Areti Smaragdi
- Academic Unit of Psychology, University of Southampton, Southampton, England, UK
| | | | - Jack Rogers
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Roberta Clanton
- School of Psychology, University of Birmingham, Birmingham, England, UK
| | - Gregor Kohls
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kerstin Konrad
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Germany
| | - Beate Herpertz-Dahlmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, Child Neuropsychology Section, University Hospital Aachen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of the RWTH, Aachen, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | | | | | - Christina Stadler
- Department of Child and Adolescent Psychiatry, University of Basel, Psychiatric University Hospital, Basel, Switzerland
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Distilling Heterogeneity among Children with Disruptive Behavior: Associations between Symptom Patterns and Social Functioning. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 46:1241-1252. [DOI: 10.1007/s10802-017-0350-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Houghton S, Carroll A, Zadow C, O’connor ES, Hattie J, Lynn S. Treating children with early-onset conduct problems and callous–unemotional traits: an empirical evaluation of KooLKIDS. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2017. [DOI: 10.1080/13632752.2017.1301646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Stephen Houghton
- Graduate School of Education, The University of Western Australia, Perth, Australia
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - Annemaree Carroll
- School of Education, The University of Queensland, Brisbane, Australia
| | - Corinne Zadow
- Graduate School of Education, The University of Western Australia, Perth, Australia
| | | | - John Hattie
- Graduate School of Education, The University of Melbourne, Melbourne, Australia
| | - Sasha Lynn
- School of Education, The University of Queensland, Brisbane, Australia
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Ter-Stepanian M, Grizenko N, Cornish K, Talwar V, Mbekou V, Schmitz N, Joober R. Attention and Executive Function in Children Diagnosed with Attention Deficit Hyperactivity Disorder and Comorbid Disorders. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2017; 26:21-30. [PMID: 28331500 PMCID: PMC5349279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 10/10/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The goal of this study was to examine the relationship between comorbid disorders and executive function (EF) in children diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD). METHODS Three hundred and fifty-five, 6-12 year old children clinically diagnosed with ADHD were included in the study. Comorbid anxiety disorders, Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) were examined. The EF domains were assessed using the Conners' Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST), Tower of London (ToL), Finger Windows (FW) and Self Ordered Pointing Test (SOPT). RESULTS The findings indicate that children with comorbid anxiety disorders performed worse in domains measured by CPT and prior to controlling for age and sex, by FW. However, once sex was controlled for the results for FW were no longer significant. Children with CD obtained lower scores on WCST. Furthermore, a significant sex by CD interaction was observed. CONCLUSION These results indicate that comorbid disorders should be carefully examined as they play a significant role in EF performance and subsequently in day-to-day functioning of children with ADHD.
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Affiliation(s)
| | - Natalie Grizenko
- Child and Adolescent Psychiatry Program, Douglas Mental Health University Institute, Montreal, Quebec
- Department of Psychiatry, McGill University, Montreal, Quebec
| | - Kim Cornish
- Centre for Developmental Psychiatry & Psychology, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Victoria Talwar
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec
| | - Valentin Mbekou
- Child and Adolescent Psychiatry Program, Douglas Mental Health University Institute, Montreal, Quebec
| | - Norbert Schmitz
- Douglas Mental Health University Institute Research Centre, Montreal, Quebec
| | - Ridha Joober
- Child and Adolescent Psychiatry Program, Douglas Mental Health University Institute, Montreal, Quebec
- Department of Psychiatry, McGill University, Montreal, Quebec
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Paliziyan A, Mehrabizade Honarman M, Arshadi N. Conduct Disorder in Student: The Predicting Role of Emotion Regulation, Callous-Unemotional Traits and Schema. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2017. [DOI: 10.17795/rijm42801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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48
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Conduct Disorder in Student: The Predicting Role of Emotion Regulation, Callous-Unemotional Traits and Schema. RAZAVI INTERNATIONAL JOURNAL OF MEDICINE 2017. [DOI: 10.5812/rijm.42801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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49
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Harvey EA, Breaux RP, Lugo-Candelas CI. Early development of comorbidity between symptoms of attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 125:154-167. [PMID: 26854502 DOI: 10.1037/abn0000090] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) are among the most common childhood disorders and frequently co-occur. The present study sought to advance our understanding of how comorbidity between ADHD and ODD develops during the preschool years by testing a cross-lagged model that integrates 2 prominent models: the developmental precursor model and the correlated risk factors model. Participants were 199 children (107 boys) who took part in a longitudinal study of preschoolers with behavior problems. Parent reports of ADHD and ODD symptoms were collected annually from ages 3 to 6 and a family history interview was administered at age 3. In support of the developmental precursors model, ADHD symptoms predicted later argumentative/defiant symptoms. In support of the correlated risk factors model, family histories of ADHD and ODD/CD symptoms were correlated risk factors that uniquely predicted ADHD and anger/irritable symptoms in children. Results suggest that the correlated risk factors model may best explain the development of comorbidity between symptoms of ADHD and anger/irritability, whereas the developmental precursors model may better explain the development of comorbidity between symptoms of ADHD and argumentative/defiance.
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Affiliation(s)
- Elizabeth A Harvey
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
| | - Rosanna P Breaux
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst
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Taşkıran S, Mutluer T, Tufan AE, Semerci B. Understanding the associations between psychosocial factors and severity of crime in juvenile delinquency: a cross-sectional study. Neuropsychiatr Dis Treat 2017; 13:1359-1366. [PMID: 28572731 PMCID: PMC5441658 DOI: 10.2147/ndt.s129517] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Juvenile delinquency is a serious and common problem. To date, several studies have focused on possible psychosocial risk factors for delinquency among youths and on the implications of childhood mental illness on child criminality. However, the literature on prevalence of psychopathology and predictors of crime severity among delinquent youths in Turkey is sparse. Therefore, the aim of this study was to show the associations between crime severity and psychosocial factors such as gender, age, criminal history, concomitant attention deficit hyperactivity disorder (ADHD) and other comorbid psychiatric conditions, along with behavioral problem domains of Child Behavior Checklist (CBCL). PARTICIPANTS AND METHODS This analytical cross-sectional study sample consisted of 52 individuals (30 females and 22 males) who were sent to a pilot detention facility in Istanbul, Turkey. The participants' age ranged from 8 to 18 years (M =13.4; SD =2.9). Self-rating scales were administered in an interview format, and the crime severity information was provided by participants' admission documents. RESULTS No differences were found in terms of gender, age, children's past history of crime and substance abuse. However, family crime history was significantly higher in the high severity crime group (P=0.026). Having one or more comorbid psychiatric disorder was associated with high crime severity (P=0.018). The most common psychiatric disorders were found to be ADHD, oppositional defiant disorder, conduct disorder (CD) and anxiety disorder. CONCLUSION Findings suggest that a family history of crime comes across as a very strong predictor of severity of crime. Among psychiatric factors, ADHD and CD were associated with commitment of more severe crimes in delinquent youths in our sample. Anxious/depressed traits as depicted by CBCL are found to be associated with less severe crimes.
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Affiliation(s)
- Sarper Taşkıran
- Department of Child and Adolescent Psychiatry, Koç University School of Medicine
| | - Tuba Mutluer
- Child and Adolescent Psychiatry Department, Koç University Hospital, Istanbul
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University School of Medicine, Bolu
| | - Bengi Semerci
- Department of Psychology, Hasan Kalyoncu University, Gaziantep.,Bengi Semerci Enstitusu, Istanbul, Turkey
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